The association between atherogenic index of plasma and the risk of new-onset hypertension in young and middle-aged individuals

Objective To investigate the correlation between atherogenic index of plasma (AIP) and new-onset hypertension in young and middle-aged population (age ＜ 60 years).

Methods  A retrospective cohort study was conducted using the prospective cohort database (Kailuan Study), selecting middle-aged and young adults who participated in the Kailuan Group employee health examination from June 2006 to October 2007 as study subjects, with a total of 43 825 participants included. The participants were divided into four groups according to the quartile of AIP: group Q1 (AIP＜−0.63); group Q2 (AIP −0.63 to ＜−0.24); group Q3 (AIP −0.24 to ＜0.23); group Q4 (AIP≥0.23). The cumulative incidence curve was plotted using the Kaplan-Meier method, and the difference between groups was compared using the log-rank test. Cox proportional hazards regression model was used to investigate the association between AIP and incident hypertension.

Results The median follow-up was 8.97 years. There were 14 680 (33.50 %) cases of new-onset hypertension. The cumulative incidence of new-onset hypertension in groups Q1 to Q4 was 34.53 %, 38.79 %, 43.26 % and 51.07%, respectively. In multivariate Cox regression analysis, the HR (95%CI) for new-onset hypertension in groups Q2 to Q4 was 1.06 (1.01–1.12), 1.11 (1.06–1.16) and 1.23 (1.17–1.29), respectively, compared with the AIP group Q1, after adjustment for confounders. For each one standard deviation (0.67) increase in mean AIP , the HR (95%CI) for new-onset hypertension was 1.08 (1.05–1.10). Sensitivity analyses were performed after excluding patients with new-onset hypertension within 2 years (n=1 887) and those taking hypoglycaemic and lipid-lowering medications (n=2 758), and the results were similar to those in the main analysis.The risk analysis for competing death was performed, and the result was similar to that of the main analysis. There was interaction between AIP group and age or gender (P＜0.05).

Conclusion AIP is an independent risk factor for new-onset hypertension in young and middle-aged people.